Individual
MRS. JEAN ELIZABETH WAGY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
WHNP
Contact information
Practice address
8600 NICOLLET AVE S, BLOOMINGTON, MN 55420-2824
(952) 886-7025
(952) 887-6696
Mailing address
8600 NICOLLET AVE S, BLOOMINGTON, MN 55420-2824
(952) 886-7025
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
R074497-1
MN
Other
Enumeration date
02/06/2007
Last updated
01/22/2010
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